Patient's question:
Irregular menstruation for a long time, from the first menstrual period at 16 years old to now at 24, the menstruation has always been abnormal, coming occasionally, and the body hair is very strong. In the meantime, blood tests were done, suspected of: Polycystic Ovary Syndrome (PCOS). Traditional Chinese medicine was taken for regulation, and Western medicine was also taken. They were effective at the time, but symptoms returned after stopping the medication. Please ask, can this condition be cured? What is the most effective treatment?Doctor's answer:
Hello: Your situation first requires active medical examination and diagnosis at the hospital. The goal of PCOS treatment is primarily to establish a normal ovulatory menstrual cycle, restore fertility, and eliminate hirsutism. Once a normal menstrual cycle is established, pregnancy can occur, the ovaries no longer produce excessive androgens, and hirsutism also disappears. The methods to restore a normal menstrual cycle are as follows.(1) Clomiphene, also known as Clomiphene Citrate or Serophene. It is now widely recognized as the first-line treatment for PCOS. Clomiphene induces the hypothalamus to release GnRH, which in turn promotes the pituitary to release FSH, promoting normal follicular development. Elevated FSH levels are key to inducing ovulation in PCOS patients. Clomiphene treatment induces ovulation in more than 80% of patients. The specific dosage is 50 mg once daily, starting from day 5 of the menstrual cycle, for 5 consecutive days. Ovulation typically occurs 7–10 days after treatment. If the treatment is ineffective after 1–2 cycles, the dose can be increased to 100 mg daily for 5 days. During treatment, basal body temperature should be measured to observe for an ovulatory biphasic pattern.
(2) Ovarian wedge resection, which involves removing a wedge-shaped portion of the ovary. Before the advent of clomiphene, the treatment for PCOS was ovarian wedge resection. The efficacy was significant. Most patients ovulated and became pregnant shortly after surgery. With the availability of clomiphene, ovarian wedge resection is rarely used today and is reserved only for patients who do not respond to medical treatment.